Neurological diagnostic tool



June 2, 1970 A. P. RUSKIN NEUROLOGICAL DIAGNOSTIC TOOL Filed June 9, 1967 INVENTOR. 1484 P IPUSK/N United States Patent 3,515,125 NEUROLOGICAL DIAGNOSTIC TOOL Asa P. Ruskin, 555 Park Ave., New York, N.Y.

Filed June 9, 1967, Ser. No. 644,878 Int. Cl. A61b 5/16 US. Cl. 128-2 7 Claims ABSTRACT OF THE DISCLOSURE The present invention relates to a neurological diagnostic tool incorporating a new concept in reflex hammers in combination with an additional device for the elicitation of cutaneous reflexes and sensory examinations.

The reflex tests most familiar to the laymen are those testing reflexes at the knee, the elbow and the ankle; there are, however, many other reflex tests performed by doctors. Neurologists and general practitioners additionally test cutaneous sensation with a pin or a device known as a Wartenberg pinwheel. Cutaneous plantar reflexes are tested by doctors using a blunt shaft of a sharpness equivalent to a large calibre knitting needle or blunt pencil.

The standard American reflex hammer is a short handled instrument of the Tomahawk design which requires that the physician use wrist action in order to strike the appropriate portion of the body and elicit a reflex response. Neurological specialists have for quite some time recognized the superiority of the long handled European type reflex hammer. In that type hammer the weight of the hammer itself creates the reflex eliciting stimulus, the thumb and index finger of the physiican being used only as a fulcrum at the grip of the hammer, the amount of force applied thereby being standardized and permitting the elimination of the highly variable amount of wrist action which is ordinarily necessary when using the short handled Tomahawk type hammer.

With regard to sensory examinations, the American reflex hammers and a portion of the European devices have included a place for storing a straight pin in the handle of the reflex hammer.

It can be seen from the recitations above that a physician conducting a neurological examination is required to carry several instruments with the concomitant storage problems and inconvenience caused thereby.

It is also evident that in using a Tomahawk reflex hammer that the wrist action used to swing the reflex hammer varies from physician to physician and also is varied each time the individual physician uses the hammer since his wrist action varies from one swing to the next. The European style hammer utilizes the weight of the hammer and the length of the handle to create a moment about the pivot point where the handle is held in order Patented June 2, 1970 to equalizethe amount of force in each application. Nonetheless, that type hammer has no provision for varying the position of the hammerhead in relation to the longitudinal axis of the handle so that the hammerhead will be in the proper alignment in relation to the portion of the body where the reflex is to be elicited for the various reflex tests. For example, when eliciting the reflex action at the knee it is desirable to have the handle held in a position roughly parallel to the tibia with the plane which contains all points on the striking surface of the hammerhead being perpendicular to the axis of both the handle and the tibia; however, when eliciting the reflex in the elbow, for example, it is desirable to have both the plane which contains all points on the striking surface of the hammerhead and the handle parallel to one another.

It is one of the objectives of my invention to combine the several devices above into one small examining tool which, when in its closed position, will readily fit into the pocket of a neurologist or general practitioner.

It is a further objective of my invention to provide a reflex hammer having a variable-position hammerhead on a telescopic handle such that reflex elicitation can be carried out in such a manner as to minimize variations in the force utilized. This is accomplished by utilizing the examiners thumb and index finger as a fulcrum supporting the gripping portion of the handle. The weighted hammerhead is allowed to drop through a degree arc, hitting the appropriate body area to elicit the desired reflex.

It is another objective of my invention to enable this one tool to be used for testing cutaneous sensation via a Wartenberg pinwheel incorporated in a multipurpose tool including a reflex hammer and a rounded point reflex tester.

This invention, then, provides the neurologist with one instrument including a reflex hammer with a two-position head and an extensible handle in combination with a Wartenberg pinwheel and a device for testing cutaneous plantar reflexes. This configuration enables the hammer to be pivotally supported in the hand so that variations in the force applied to the body are minimized, since the force is caused solely by the weight of the head swinging through a set are, i.e. 90 degrees, at the end of a fixed distance moment arm. This configuration also provides for changing the head to accommodate usage for a varied number of reflex tests.

FIG. 1 is a perspective view showing my neurological diagnostic tool in one of its practical uses, eliciting the knee reflex.

FIG. 2 is a side view of a preferred embodiment of my invention, partially in longitudinal section;

FIG. 3 is the side view taken along line 3-3 of FIG. 2;

FIG. 4 is a side view of a preferred embodiment of my invention in the closed position, in longitudinal section;

FIG. 5 is a partial perspective view of the Wartenberg pinwheel section of my invention with the cover in the retracted position uncovering the pinwheel and showing the blunted point incorporated in said cover.

Referring now to the drawing, FIGS. 1 through 5, there is shown there a preferred embodiment of my invention. However, the specific embodiment there shown is merely set out in compliance with the statutory requirements of 35 U.S.C. 112, other embodiments of my invention based on this disclosure will be obvious to those skilled in the art.

Reference number shows the hammer of my invention in use to elicit the patellar reflex. In FIG. 2, the hammer 10 is shown with the handle 11 and the inner telescoping portion 12 of the handle in the extended position. Handle 11 has a grip portion 32. Likewise, there is shown the two-position socket 13 attached to the end of the telescoping portion 12 of the handle furthest from the grip of the handle 11. Movably mounted in the socket 13 is the disc-shaped head 15. The head 15 is shown in the position perpendicular to the longitudinal axis of both the handle '11 and the extension portion of the handle 12. The disc-shaped head of the hammer 15 has a soft rubber annular rim 16 covering the edges 17 of disc-shaped head 15. The soft rubber annular rim 16 is again shown in FIG. 3. It can be seen in FIG. 1 that when reflexes are elicited with the plane of the discshaped head 15 perpendicular to the longitudinal axis of handle 11 the surface striking the body portion where the reflex is to be elicited is that portion of the discshaped head 15 which is entirely covered by the soft rubber annular rim 16.

When the telescoping portion of the handle 12 is in the extended position as shown in FIG. 2, the telescoping portion 12 passes through the opening '18 of the handle 11 provided for that purpose. The telescoping portion of handle 12 has at its end opposite the socket 13 a protrusion 19 which protrusion is of a diameter slightly smaller than the bore 20 of handle 11, but is of a diameter greater than opening 18 through which the extension portion of the handle 12 extends. The bore 20 is narrowed in the vicinity of longitudinal slot 22 and again immediately in front of slot 21 in such a manner that protrusion 19 has a friction fit with bore 20 when the handles telescoping portion 12 is in either the fully extended position (FIG. 2) or the fully closed position (FIG. 4).

The disc-shaped head portion 15 is shown in FIG. 4 with the plane of the disc-shaped head in a position parallel to the longitudinal axis of handle 11 and extension portion of the handle 12, the extension portion of the handle 12 being shown in its retracted position residing inside the longitudinal bore 20 of handle 11.

Longitudinal slot 22 connects with opening 18; the longitudinal slot 22 provides a seat for neck 23 of the disc-shaped head 15 when the extension portion of the handle '12 is in the retracted position and the disc-shaped head 15 is in position parallel to the longitudinal axis of the handle. At the end of the handle 11 opposite opening 18 there is rotatably mounted a Wartenberg pinwheel 25. This Wartenberg pinwheel 25 is positioned so that the pointed projections 26 thereof extend through longitudinal slot 24 in the handle 11, sufficient amounts of each pointed projection 26 passing through the slot 24 so that contact can be made between the points and the desired skin area being tested.

A sliding cover 27 is provided for the Wartenberg pinwheel 25 when the Wartenberg pinwheel 2-5 is not being used. Sliding cover 27 has two positions, in one position cover 27 houses Wartenberg pinwheel 25 and in the other position the cover is locked on the handle exposing the Wartenberg pinwheel. A friction fit between the sliding cover 27 and the outer diameter of handle 11 at the end 31 of handle 11 furthest from opening 18 prevents loss of cover 27. The detachable cover 27 is also provided with projecting housing 29 into which the exposed pin portions 26 of the Wartenberg pinwheel 25 project, the walls of the housing encasing the projecting pins of the Wartenberg pinwheel 25. The. walls 28 are connected by a ridge-shaped blunt projection 30 which is shaped so that in cross-section it resembles the point of a blunt knitting needle. The ridge-shaped blunt projection 30 is utilized for testing the cutaneous plantar reflexes.

FIG. 4 shows my hammer in the closed position with cover 27 in place and head 15 in a position parallel to the longitudinal axis of the handle; in this configuration my invention is readily carried in the pocket of the physician using the same or is readily placed in even the smallest of physicians bags.

What is claimed is:

1. A hammer for use by an operator in testing a subjects neurological reflexes comprising a handle having a grip portion at one end and a socket portion located at the end opposite said grip portion, and a disc-shaped hammerhead including an annular rim, said hammerhead moveably mounted in said socket portion in one of two positions relative to said handle, in one of said positions the plane of the annular rim is parallel to the longitudinal axis of the handle and in the other of said positions the plane of the annular rim is perpendicular to the longitudinal axis of said handle.

2. A hammer for testing neurological reflexes in accordance with claim 1 wherein said handle has an elongated outer grip section and an elongated inner section, said inner section having at one end a socket, and the other end of said inner section residing within said outer section, said inner section having a retracted and an extended position within said outer section and having means for locking said inner section in said extended position and also in said retracted position in relation to said outer section.

3. A hammer for testing neurological reflexes in ac-. cordance with claim 1 further comprising a covering surrounding said head portion.

4. A hammer for testing neurological reflexes in ac1- cordance wtih claim 3 wherein said covering consists of a firm resilient material.

5. A hammer for use by an operator in testing a subjects neurological reflexes comprising:

a disc-shaped head having an annular rim portion adapted to contact the body of the subject during tests and a handle connected at one end portion thereof to the central portion of said disc-shaped head, said handle being articulated adjacent to said end portion to enable said disc-shaped head to be placed in a selectable one of a position in which said rim portion is disposed in a plane perpendicular to the longitudinal axis of said handle and another position in which said rim portion is in a plane parallel to the longitudinal axis of said handle, the other end portion of said handle being adapted to be pivotally supported by the operator conducting the testing, whereby the rim of said disc-shaped head when said disc-shaped head is placed in either of its selectable positions relative to said handle can be directed to strike the body of the subject as said disc-shaped head swings with said handle about the pivotally supported other end portion thereof.

6. In a neurological diagnostic tool the combination comprising a disc-shaped head having an annular rim portion adapted to contact the body of the subject during tests, a handle connected at one end portion thereof to the central portion of said disc-shaped head, said handle being articulated adjacent to said end portion to enable said disc-shaped head to be placed in a selectable one of a position in which said rim portion is in a plane parallel to the longitudinal axis of said handle, the other end portion of said handle being adapted to be pivotally supported by the operator conducting the testing, a pinwheel rotatably mounted at the end portion of said handle opposite the end of the handle connected to said disc-, shaped head, and a cover slidably mounted on said handle over said pinwheel.

7. In a neurological diagnostic tool of the type described in claim 6 wherein said cover is slidably mounted in one of two positions, in only one of the two said posia tions the cover conceals the pinwheel, said cover further having a blunt projection thereon projecting outwardly thereof for use in testing cutaneous plantar reflexes.

(References on following P References Cited 3,185,146 5/1965 Leopoldi 128-2 UNITED STATES PATENTS 3,3 ,781 10/1967 Allen 128-2 XR 5/1918 Karatsu 1282 FOREIGN PATENTS 12/1918 Parrella 7- 563,469 9/1923 France.

9/ 1931 Ervay 14529 5 3/1943 Newstedt et a1 128-2 RICHARD A. GAUDET, Primary Examiner 10/1943 Gray 1282 11/1950 Golub et a]. K. L. HOWELL, Asslstant Exammer 1 ues 1/1963 1Kevorkian 128-2 81-177; 14529, 61 

